HB-5819, As Passed House, May 30, 2018
April 17, 2018, Introduced by Reps. Kesto, Vaupel and Guerra and referred to the Committee on Health Policy.
A bill to amend 1974 PA 258, entitled
"Mental health code,"
by amending sections 100a, 400, 415, 416, 419, and 420 (MCL
330.1100a, 330.1400, 330.1415, 330.1416, 330.1419, and 330.1420),
sections 100a and 420 as amended by 2016 PA 320, section 400 as
amended by 2004 PA 553, section 415 as amended by 2004 PA 557,
section 416 as amended by 1995 PA 290, and section 419 as amended
by 1984 PA 186.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 100a. (1) "Abilities" means the qualities, skills, and
competencies of an individual that reflect the individual's talents
and acquired proficiencies.
(2) "Abuse" means nonaccidental physical or emotional harm to
a recipient, or sexual contact with or sexual penetration of a
recipient as those terms are defined in section 520a of the
Michigan penal code, 1931 PA 328, MCL 750.520a, that is committed
by an employee or volunteer of the department, a community mental
health services program, or a licensed hospital or by an employee
or volunteer of a service provider under contract with the
department, community mental health services program, or licensed
hospital.
(3) "Adaptive skills" means skills in 1 or more of the
following areas:
(a) Communication.
(b) Self-care.
(c) Home living.
(d) Social skills.
(e) Community use.
(f) Self-direction.
(g) Health and safety.
(h) Functional academics.
(i) Leisure.
(j) Work.
(4) "Adult foster care facility" means an adult foster care
facility licensed under the adult foster care facility licensing
act, 1979 PA 218, MCL 400.701 to 400.737.
(5) "Alcohol and drug abuse counseling" means the act of
counseling, modification of substance use disorder related
behavior, and prevention techniques for individuals with substance
use disorder, their significant others, and individuals who could
potentially develop a substance use disorder.
(6) "Applicant" means an individual or his or her legal
representative who makes a request for mental health services.
(7) "Approved service program" means a substance use disorder
services program licensed under part 62 of the public health code,
1978 PA 368, MCL 333.6230 to 333.6251, to provide substance use
disorder treatment and rehabilitation services by the department-
designated community mental health entity and approved by the
federal government to deliver a service or combination of services
for the treatment of incapacitated individuals.
(8) "Assisted outpatient treatment" or "AOT" means the
categories of outpatient services ordered by the court under
section 468 or 469a. Assisted outpatient treatment may include case
management services to provide care coordination under the
supervision of a psychiatrist and developed in accordance with
person-centered planning under section 712. Assisted outpatient
treatment may also include 1 or more of the following categories of
services: medication; periodic blood tests or urinalysis to
determine compliance with prescribed medications; individual or
group therapy; day or partial day programming activities;
vocational, educational, or self-help training or activities;
assertive community treatment team services; alcohol or substance
use disorder treatment and counseling and periodic tests for the
presence of alcohol or illegal drugs for an individual with a
history of alcohol abuse or substance use disorder; supervision of
living arrangements; and any other services within a local or
unified services plan developed under this act that are prescribed
to treat the individual's mental illness and to assist the
individual in living and functioning in the community or to attempt
to prevent a relapse or deterioration that may reasonably be
predicted to result in suicide, the need for hospitalization, or
serious violent behavior. The medical review and direction included
in an assisted outpatient treatment plan shall be provided under
the supervision of a psychiatrist.
(9) "Board" means the governing body of a community mental
health services program.
(10) "Board of commissioners" means a county board of
commissioners.
(11) "Center" means a facility operated by the department to
admit individuals with developmental disabilities and provide
habilitation and treatment services.
(12) "Certification" means formal approval of a program by the
department in accordance with standards developed or approved by
the department.
(13) "Child abuse" and "child neglect" mean those terms as
defined in section 2 of the child protection law, 1975 PA 238, MCL
722.622.
(14) "Child and adolescent psychiatrist" means 1 or more of
the following:
(a) A physician who has completed a residency program in child
and adolescent psychiatry approved by the Accreditation Council for
Graduate Medical Education or the American Osteopathic Association,
or who has completed 12 months of child and adolescent psychiatric
rotation and is enrolled in an approved residency program as
described in this subsection.
(b) A psychiatrist employed by or under contract as a child
and adolescent psychiatrist with the department or a community
mental health services program on March 28, 1996, who has education
and clinical experience in the evaluation and treatment of children
or adolescents with serious emotional disturbance.
(c) A psychiatrist who has education and clinical experience
in the evaluation and treatment of children or adolescents with
serious emotional disturbance who is approved by the director.
(15) "Children's diagnostic and treatment service" means a
program operated by or under contract with a community mental
health services program, that provides examination, evaluation, and
referrals for minors, including emergency referrals, that provides
or facilitates treatment for minors, and that has been certified by
the department.
(16) "Community mental health authority" means a separate
legal public governmental entity created under section 205 to
operate as a community mental health services program.
(17) "Community mental health organization" means a community
mental health services program that is organized under the urban
cooperation act of 1967, 1967 (Ex Sess) PA 7, MCL 124.501 to
124.512.
(18) "Community mental health services program" means a
program operated under chapter 2 as a county community mental
health agency, a community mental health authority, or a community
mental health organization.
(19) "Consent" means a written agreement executed by a
recipient, a minor recipient's parent, or a
recipient's legal
representative with authority to execute a consent, or a full or
limited guardian authorized under the estates and protected
individuals code, 1998 PA 386, MCL 700.1101 to 700.8206, with the
authority to consent, or a verbal agreement of a recipient that is
witnessed and documented by an individual other than the individual
providing treatment.
(20) "County community mental health agency" means an official
county or multicounty agency created under section 210 that
operates as a community mental health services program and that has
not elected to become a community mental health authority or a
community mental health organization.
(21) "Department" means the department of health and human
services.
(22) "Department-designated community mental health entity"
means the community mental health authority, community mental
health organization, community mental health services program,
county community mental health agency, or community mental health
regional entity designated by the department to represent a region
of community mental health authorities, community mental health
organizations, community mental health services programs, or county
community mental health agencies.
(23) "Dependent living setting" means all of the following:
(a) An adult foster care facility.
(b) A nursing home licensed under article 17 part 217 of the
public health code, 1978 PA 368, MCL 333.20101 to
333.22260.333.21701 to 333.21799e.
(c) A home for the aged licensed under article 17 part 213 of
the public health code, 1978 PA 368, MCL 333.20101 to
333.22260.333.21301 to 333.21335.
(24) "Designated representative" means any of the following:
(a) A registered nurse or licensed practical nurse licensed or
otherwise authorized under part 172 of the public health code, 1978
PA 368, MCL 333.17201 to 333.17242.
(b) A paramedic licensed or otherwise authorized under part
209 of the public health code, 1978 PA 368, MCL 333.20901 to
333.20979.
(c) A physician's assistant licensed or otherwise authorized
under part 170 or 175 of the public health code, 1978 PA 368, MCL
333.17001 to 333.17084 and 333.17501 to 333.17556.
(d) An individual qualified by education, training, and
experience who performs acts, tasks, or functions under the
supervision of a physician.
(25) "Developmental disability" means either of the following:
(a) If applied to an individual older than 5 years of age, a
severe, chronic condition that meets all of the following
requirements:
(i) Is attributable to a mental or physical impairment or a
combination of mental and physical impairments.
(ii) Is manifested before the individual is 22 years old.
(iii) Is likely to continue indefinitely.
(iv) Results in substantial functional limitations in 3 or
more of the following areas of major life activity:
(A) Self-care.
(B) Receptive and expressive language.
(C) Learning.
(D) Mobility.
(E) Self-direction.
(F) Capacity for independent living.
(G) Economic self-sufficiency.
(v) Reflects the individual's need for a combination and
sequence of special, interdisciplinary, or generic care, treatment,
or other services that are of lifelong or extended duration and are
individually planned and coordinated.
(b) If applied to a minor from birth to 5 years of age, a
substantial developmental delay or a specific congenital or
acquired condition with a high probability of resulting in
developmental disability as defined in subdivision (a) if services
are not provided.
(26) "Director" means the director of the department or his or
her designee.
(27) "Discharge" means an absolute, unconditional release of
an individual from a facility by action of the facility or a court.
(28) "Eligible minor" means an individual less than 18 years
of age who is recommended in the written report of a
multidisciplinary team under rules promulgated by the department of
education to be classified as 1 of the following:
(a) Severely mentally impaired.
(b) Severely multiply impaired.
(c) Autistic impaired and receiving special education services
in a program designed for the autistic impaired under subsection
(1) of R 340.1758 of the Michigan administrative code
Administrative Code or in a program designed for the severely
mentally impaired or severely multiply impaired.
(29) "Emergency situation" means a situation in which an
individual is experiencing a serious mental illness or a
developmental disability, or a minor is experiencing a serious
emotional disturbance, and 1 of the following applies:
(a) The individual can reasonably be expected within the near
future to physically injure himself, herself, or another
individual, either intentionally or unintentionally.
(b) The individual is unable to provide himself or herself
food, clothing, or shelter or to attend to basic physical
activities such as eating, toileting, bathing, grooming, dressing,
or ambulating, and this inability may lead in the near future to
harm to the individual or to another individual.
(c) The individual has mental illness that has impaired his or
her judgment so that the individual is unable to understand his or
her need for treatment, and that impaired judgment, on the basis of
competent clinical opinion, presents a substantial risk of
significant physical or mental harm to the individual in the near
future or presents a substantial risk of significant physical harm
to others in the near future.
(30) "Executive director" means an individual appointed under
section 226 to direct a community mental health services program or
his or her designee.
Sec. 400. As used in this chapter, unless the context requires
otherwise:
(a) "Clinical certificate" means the written conclusion and
statements of a physician or a licensed psychologist that an
individual is a person requiring treatment, together with the
information and opinions, in reasonable detail, that underlie the
conclusion, on the form prescribed by the department or on a
substantially similar form.
(b) "Competent clinical opinion" means the clinical judgment
of a physician, psychiatrist, or licensed psychologist.
(c) "Court" means the probate court or the court with
responsibility with regard to mental health services for the county
of residence of the subject of a petition, or for the county in
which the subject of a petition was found.
(d) "Formal voluntary hospitalization" means hospitalization
of an individual based on both of the following:
(i) The execution of an application for voluntary
hospitalization by the individual or by a patient advocate
designated under the estates and protected individuals code, 1998
PA 386, MCL 700.1101 to 700.8102, 700.8206, to make mental health
treatment decisions for the individual.
(ii) The hospital director's determination that the individual
is clinically suitable for voluntary hospitalization.
(e) "Informal voluntary hospitalization" means hospitalization
of an individual based on all of the following:
(i) The individual's request for hospitalization.
(ii) The hospital director's determination that the individual
is clinically suitable for voluntary hospitalization.
(iii) The individual's agreement to accept treatment.
(f) "Involuntary mental health treatment" means court-ordered
hospitalization, alternative treatment, or combined hospitalization
and alternative treatment as described in section 468. For the
purpose of this chapter, involuntary mental health treatment does
not include a full or limited guardian authorized under the estates
and protected individuals code, 1998 PA 386, MCL 700.1101 to
700.8206, with the authority to consent to mental health treatment
for an individual found to be a legally incapacitated individual
under the estates and protected individuals code, 1998 PA 386, MCL
700.1101 to 700.8206.
(g) "Mental illness" means a substantial disorder of thought
or mood that significantly impairs judgment, behavior, capacity to
recognize reality, or ability to cope with the ordinary demands of
life.
(h) "Preadmission screening unit" means a service component of
a community mental health services program established under
section 409.
(i) "Private-pay patient" means a patient whose services and
care are paid for from funding sources other than the community
mental health services program, the department, or other state or
county funding.
(j) "Release" means the transfer of an individual who is
subject to an order of combined hospitalization and alternative
treatment from 1 treatment program to another in accordance with
his or her individual plan of services.
(k) "Subject of a petition" means an individual regarding whom
a petition has been filed with the court asserting that the
individual is or is not a person requiring treatment or for whom an
objection to involuntary mental health treatment has been made
under section 484.
Sec. 415. Subject to section 410, an individual 18 years of
age or over may be hospitalized or otherwise treated as a formal
voluntary
patient if the either of
the following applies:
(a)
The individual executes an
application a written consent
with
the mental health facility for hospitalization
mental health
treatment
as a formal voluntary patient. or
the individual assents
and
the
(b)
The full guardian of the individual,
the or limited
guardian
with authority to admit, execute
a written consent to
mental health treatment, or a patient advocate authorized by the
individual to make mental health treatment decisions under the
estates and protected individuals code, 1998 PA 386, MCL 700.1101
to
700.8102, executes an application for hospitalization and if the
hospital
director considers the individual to be clinically
suitable
for that form of hospitalization.700.8206,
executes a
written consent to provide mental health treatment.
Sec.
416. The formal application shall contain in large type
and
simple language the substance of sections 419 and 420. Upon
hospitalization,
commencement of mental health
treatment, the
rights
set forth in the application shall that the patient has
during the mental health treatment, including the right to object
to the mental health treatment, must be orally communicated to the
patient
and to the individual who executed the application. written
consent.
In addition, a copy of the application
shall written
consent must be given to the patient and the individual who
executed
the application written
consent and to 1 other individual
designated by the patient.
Sec. 419. (1) Except as is provided in section 420, a formal
voluntary patient 18 years of age or over shall not be hospitalized
or provided mental health treatment for more than 3 days, excluding
Sundays and holidays, after the patient, the full or limited
guardian with authority to consent to mental health treatment, or a
patient advocate authorized by the individual to make mental health
treatment decisions under the estates and protected individuals
code, 1998 PA 386, MCL 700.1101 to 700.8206, gives written notice
of
an intention to terminate his or her hospitalization and leave
the
hospital.the patient's mental
health treatment.
(2) When the hospital or provider of mental health treatment
is
told of an intention to terminate hospitalization mental health
treatment under subsection (1), it shall promptly supply the
written
form which that is required.
Sec. 420. If a written notice of termination of
hospitalization
mental health treatment is given to a hospital or
provider of mental health treatment under section 419, if the
notice is not withdrawn, and if the hospital director or provider
of mental health treatment determines that the patient is a person
requiring treatment and should remain in the hospital or continue
to receive mental health treatment, the hospital director, provider
of mental health treatment, or other suitable person shall within 3
days
after the hospital's receipt of the notice , file a petition
with the court that complies with section 434. The petition shall
be accompanied by 1 clinical certificate executed by a psychiatrist
and 1 clinical certificate executed by either a physician or a
licensed psychologist. If a petition is filed, the hospital or
provider of mental health may continue hospitalization or mental
health treatment of the patient pending hearings convened under
sections 451 to 465.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.
Enacting section 2. This amendatory act does not take effect
unless Senate Bill No.____ or House Bill No. 5818 (request no.
03397'17) of the 99th Legislature is enacted into law.